<?php
/* @var $this PotentialCustomersController */
/* @var $model PotentialCustomers */
/* @var $form CActiveForm */
?>

<div class="form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'id'=>'potential-customers-form',
	'enableAjaxValidation'=>false,
)); ?>

	<p class="note">Fields with <span class="required">*</span> are required.</p>

	<?php echo $form->errorSummary($model); ?>

	<div class="row">
		<?php echo $form->labelEx($model,'potential_customers_list_id'); ?>
		<?php //echo $form->textField($model,'potential_customers_list_id'); ?>
		<?php echo $form->dropDownList($model, 'potential_customers_list_id',CHtml::listData( PotentialCustomersList::model()->findAll(), 'potential_customers_list_id', 'potential_customers_list_name')  );?>
		<?php echo $form->error($model,'potential_customers_list_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'first_name'); ?>
		<?php echo $form->textField($model,'first_name',array('size'=>50,'maxlength'=>50)); ?>
		<?php echo $form->error($model,'first_name'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'last_name'); ?>
		<?php echo $form->textField($model,'last_name',array('size'=>50,'maxlength'=>50)); ?>
		<?php echo $form->error($model,'last_name'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'gender'); ?>
		<?php echo $form->dropDownList($model,'gender',array('Mr'=>'Mr','Mrs'=>'Mrs','Ms'=>'Ms','Miss'=>'Miss','Dr'=>'Dr',''=>'--')); ?>
		<?php echo $form->error($model,'gender'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'mobile'); ?>
		<?php echo $form->textField($model,'mobile',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'mobile'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'email'); ?>
		<?php echo $form->textField($model,'email',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'email'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'address'); ?>
		<?php echo $form->textField($model,'address',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'address'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'post_code'); ?>
		<?php echo $form->textField($model,'post_code',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'post_code'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail1'); ?>
		<?php echo $form->textField($model,'customer_detail1',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail1'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail2'); ?>
		<?php echo $form->textField($model,'customer_detail2',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail2'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail3'); ?>
		<?php echo $form->textField($model,'customer_detail3',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail3'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail4'); ?>
		<?php echo $form->textField($model,'customer_detail4',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail4'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail5'); ?>
		<?php echo $form->textField($model,'customer_detail5',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail5'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail6'); ?>
		<?php echo $form->textField($model,'customer_detail6',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail6'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail7'); ?>
		<?php echo $form->textField($model,'customer_detail7',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail7'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail8'); ?>
		<?php echo $form->textField($model,'customer_detail8',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail8'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail9'); ?>
		<?php echo $form->textField($model,'customer_detail9',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail9'); ?>
	</div>

	<div class="row">
		<?php echo $form->labelEx($model,'customer_detail10'); ?>
		<?php echo $form->textField($model,'customer_detail10',array('size'=>60,'maxlength'=>255)); ?>
		<?php echo $form->error($model,'customer_detail10'); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton($model->isNewRecord ? Yii::t('base','Create') : Yii::t('base','Save')); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- form -->